Dezaray Lazair McDonald, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

26028446A Issued in IN

Practice address

3606 N Newton St
Jasper, IN 47546-9601

Phone

(812) 481-1513

Fax

(812) 481-1593

NPI assigned

Aug 25, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Jasper, IN
  • NPI 1962583138
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1013520592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 N NEWTON ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469601",
            "telephone_number": "812-481-1513",
            "fax_number": "812-481-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 N NEWTON ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469601",
            "telephone_number": "812-481-1513",
            "fax_number": "812-481-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DEZARAY",
        "middle_name": "LAZAIR",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26028446A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "7120015026",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Walgreens",
            "affiliation": "N",
            "address_1": "3606 N Newton St",
            "city": "Jasper",
            "state": "IN",
            "country_code": "US",
            "postal_code": "475469601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ila R Mason, FNP-C
• Stephanie M Matthews, MSW, LSW
• Paula Kaye McCarter-Carlisle, FNP-C
• Timothy M McClure, MD
• Jill Marie McCune
• Siera Nicole McEwen
• Shea McGovren, PTA
• Parker Wilson McIntyre
• Medical of Dubois a Professional Corporation
• Terri Medlock, MSN WHNP

• Pharmacist in Jasper, IN
• Providers in Jasper, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.